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Effectiveness and safety of a simple home-based rehabilitation program in pulmonary arterial hypertension: an interventional pilot study.

BMC Sports Sci Med Rehabil 2021 Jul 28;13(1):79. Epub 2021 Jul 28.

Department of Population Medicine and Lifestyle Diseases Prevention, Medical University of Bialystok, Bialystok, Poland.

Background: Rehabilitation plays an important role in the management of patients with pulmonary arterial hypertension (PAH) and current guidelines recommend implementation of a monitored individualized exercise training program as adjuvant therapy for stable PAH patients on optimal medical treatment. An optimal rehabilitation model for this group of patients has not yet been established. This randomized prospective study assessed the effectiveness and safety of a 6-month home-based caregiver-supervised rehabilitation program among patients with pulmonary arterial hypertension. Read More

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BEST of Surgical Training: the pan-London Core Surgical Training induction programme: "There's no I in team, but there is a me."

Surgeon 2021 Jul 22. Epub 2021 Jul 22.

Higher and Core Surgery Training Programme Director, Health Education England (HEE), Stewart House, 32 Russell Square, London, WC1B 5DN, UK; Croydon University Hospital, 530 London Road, Croydon, CR7 7YE, London, UK. Electronic address:

Background: In the UK, Core Surgical Training (CST) marks the start of a surgical career, but previous experience and skills vary widely. Whilst Individual hospital Trusts offer local inductions, these are generally of a generic, administrative nature rather than advising trainees on how best to harness training opportunities. We designed a regional induction programme, 'Building Excellence in Surgical Training' (BEST) to address this, develop essential technical and non-technical skills, and engender support networks. Read More

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Carbimazole induced rhabdomyolysis.

Endocrinol Diabetes Metab Case Rep 2021 Jul 1;2021. Epub 2021 Jul 1.

Department of Endocrinology, University of Western Australia, Perth, Western Australia, Australia.

Summary: Carbimazole is a commonly used antithyroid drug (ATD), which is associated with several well-established side effects. However, Carbimazole-induced rhabdomyolysis is rarely reported in the literature. We report a 27-year-old male who presented with upper limb myalgia and significantly raised creatine kinase elevation, 1-month post commencement of Carbimazole for Graves' disease. Read More

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Orthogeriatrics: a vital requirement for improving fragility fracture patient care internationally with particular reference to Turkey.

Arch Osteoporos 2021 Jun 26;16(1):103. Epub 2021 Jun 26.

Department of Public Health, Epidemiology and Health Economics, Liège Medical School, University of Liège, Liège, Belgium.

Purpose: Orthogeriatrics is a team approach that aims to provide adequate and timely intervention for individuals suffering from fragility fractures, particularly hip fractures. These patients are mostly the frailest older adults. The aim of orthogeriatrics is to re-gain functionality as early as possible and to decrease disability and mortality. Read More

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An Initial Preparation for Human Cadaveric Dissection Ameliorates the Associated Mental Distress in Students.

Anat Sci Educ 2021 Jun 18. Epub 2021 Jun 18.

School of Occupational Therapy, College of Health Sciences, Husson University, Bangor.

It is universally recognized that cadaveric dissection is an essential part of anatomy training. However, it has been reported to induce mental distress in some students and impair their intrinsic motivation to study. One of the postulated reasons for this behavior is the lack of adequate information and preparation of students for cadaveric dissection. Read More

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Dysphagia in Pediatric Patients with Tracheostomy.

Ann Otol Rhinol Laryngol 2021 Jun 18:34894211025179. Epub 2021 Jun 18.

Department of Otolaryngology, UPMC Children's Hospital of Pittsburgh, Pittsburgh, PA, USA.

Objective: Post-tracheotomy swallowing function has not been well described in the pediatric population. This study aims to (1) determine differences in swallowing functioning pre- and post-tracheotomy and (2) examine the association between postoperative dysphagia and indication for tracheotomy, age at the time of tracheotomy, and time between tracheotomy and modified barium swallow (MBS).

Methods: A retrospective chart review was performed on 752 patients who underwent a tracheotomy from 2003 to 2018 and had adequate documentation for review. Read More

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Docetaxel-induced interstitial lung disease among patients with breast cancer: a case series and review of literature.

Respirol Case Rep 2021 Jul 13;9(7):e00802. Epub 2021 Jun 13.

National Hospital for Respiratory Diseases Welisara Sri Lanka.

Taxane-induced pneumotoxicity is rare. However, 1-5% of patients taking docetaxel may develop severe pneumotoxicity. This has been limited to case reports in the literature. Read More

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Effectiveness of Video-Based Online Training for Health Care Workers to Prevent COVID-19 Infection: An Experience at a Tertiary Care Level Institute, Uttarakhand, India.

Cureus 2021 May 1;13(5):e14785. Epub 2021 May 1.

Pathology, All India Institute of Medical Sciences, Rishikesh, IND.

Purpose Amidst the current COVID-19 pandemic, traditional teaching methodology took a back foot. However, an urgent need for training health care worker (HCW) on preventive measures for COVID-19 infection was the need of the hour. Keeping in mind the precautionary measures required to combat COVID-19 infection, the only promising option for training was by adopting an online learning method. Read More

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A case series with literature review on adjunctive usage of intravitreal ceftazidime in ocular syphilis with human immunodeficiency virus infection.

Int J STD AIDS 2021 May 8:9564624211011917. Epub 2021 May 8.

University Malaya Eye Research Centre, Department of Ophthalmology, Faculty of Medicine, University of Malaya, Malaysia.

Background: Penicillin is the conventional treatment for all stages of syphilis, including ocular and neurosyphilis, according to the recommendations by the Centre for Disease Control and Prevention Sexually Transmitted Disease. This case series highlighted three cases of ocular syphilis which showed prompt treatment response as early as 24 h after the adjunctive intravitreal ceftazidime injection.

Methods: Case Series. Read More

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A 45-year-old female patient with Sheehan's syndrome presenting with imminent adrenal crisis: a case report.

J Med Case Rep 2021 May 8;15(1):229. Epub 2021 May 8.

Department of Epidemiology and Biostatistics, School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia.

Background: Sheehan's syndrome is hypopituitarism due to pituitary gland necrosis resulting from hemorrhagic shock during pregnancy. It is a rare complication with varied manifestations and a considerable delay in diagnosis.

Case Presentation: We describe the case of a 45-year-old Ethiopian woman who presented with generalized fatigue for 18 years which progressed to anorexia, nausea, vomiting, diarrhea, and abdominal pain of 6 years' duration, for which she was treated symptomatically throughout these years. Read More

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A nurse-led intervention to improve management of virological failure in public sector HIV clinics in Durban, South Africa: A pre- and post-implementation evaluation.

S Afr Med J 2021 Mar 31;111(4):299-303. Epub 2021 Mar 31.

Centre for the AIDS Programme of Research in South Africa (CAPRISA), University of KwaZulu-Natal, Durban, South Africa; Department of Infectious Diseases, Nelson R Mandela School of Medicine, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa.

Background: Identification of patients on antiretroviral therapy (ART) with virological failure (VF) and the response in the public health sector remain significant challenges. We previously reported improvement in routine viral load (VL) monitoring after ART commencement through a health system-strengthening, nurse-led 'VL champion' programme as part of a multidisciplinary team in three public sector clinics in Durban, South Africa.

Objectives: To report on the impact of the VL champion model adapted to identify, support and co-ordinate the management of individuals with VF on first-line ART in a setting with limited electronic-based record capacity. Read More

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Rehabilitation status of children with cerebral palsy in Bangladesh: Findings from the Bangladesh Cerebral Palsy Register.

PLoS One 2021 3;16(5):e0250640. Epub 2021 May 3.

CSF Global, Dhaka, Bangladesh.

Objective: The objective of this study was to assess the rehabilitation status and factors associated with rehabilitation service utilisation among children with cerebral palsy (CP) in Bangladesh.

Materials And Methods: This is a population-based surveillance study conducted among children with CP registered in the Bangladesh CP Register (BCPR), the first population-based register of children with CP aged <18 years (y) in Bangladesh. Children with CP were identified from the community using the key informant method and underwent a detailed neurodevelopmental assessment. Read More

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Clinical Utility of Antiretinal Antibody Testing.

JAMA Ophthalmol 2021 Jun;139(6):658-662

Department of Neurology, Mayo Clinic, Rochester, Minnesota.

Importance: The clinical utility of most antiretinal antibodies (retina antibodies) currently available for testing remains unclear and unproven. Despite this, the presence of retinal antibodies is included in current diagnostic autoimmune retinopathy criteria.

Objective: To evaluate the clinical significance of comprehensive retinal antibody evaluations currently offered in North America. Read More

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Differences in antibiotic and antiviral use in people with confirmed influenza: a retrospective comparison of rapid influenza PCR and multiplex respiratory virus PCR tests.

BMC Infect Dis 2021 Apr 7;21(1):321. Epub 2021 Apr 7.

Department of Infectious Diseases, Prince of Wales Hospital, Randwick, Sydney, NSW, Australia.

Background: Influenza is a highly contagious respiratory virus with clinical impacts on patient morbidity, mortality and hospital bed management. The effect of rapid nucleic acid testing (RPCR) in comparison to standard multiplex PCR (MPCR) diagnosis in treatment decisions is unclear. This study aimed to determine whether RPCR influenza testing in comparison to standard MPCR testing was associated with differences in antibiotic and antiviral (oseltamivir) utilisation and hospital length of stay in emergency department and inpatient hospital settings. Read More

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Joint development recovery on resumption of embryonic movement following paralysis.

Dis Model Mech 2021 Apr 22;14(4). Epub 2021 Apr 22.

Department of Zoology, School of Natural Sciences, University of Dublin, Trinity College Dublin, Dublin, Ireland.

Fetal activity in utero is a normal part of pregnancy and reduced or absent movement can lead to long-term skeletal defects, such as Fetal Akinesia Deformation Sequence, joint dysplasia and arthrogryposis. A variety of animal models with decreased or absent embryonic movements show a consistent set of developmental defects, providing insight into the aetiology of congenital skeletal abnormalities. At developing joints, defects include reduced joint interzones with frequent fusion of cartilaginous skeletal rudiments across the joint. Read More

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Comparing the effects of self-management and hospital-based pulmonary rehabilitation programs in COPD patients.

Niger J Clin Pract 2021 Mar;24(3):362-368

Cyprus Science University, Health Sciences Faculty, Girne, Cyprus, TRNC, Cyprus.

Background: Pulmonary rehabilitation (PR) is a core component of the management of patients with chronic obstructive pulmonary disease (COPD). Although several types of PR programs are implemented for patients with COPD on the basis of patient preferences or clinical protocols, the clinical efficiencies of these programs may vary, with each program having its own unique purpose, procedures, benefits, challenges, and effectiveness.

Aim: The aim of this study was to compare the effects of self-management and hospital-based PR programs in COPD patients. Read More

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A Multicenter Study of Patient Acceptability of the IBD Disk Tool and Patient-Reported Disabilities.

Dig Dis Sci 2021 Mar 15. Epub 2021 Mar 15.

NIHR Biomedical Research Centre, Queen Elizabeth Hospital Birmingham, Institute of Translational Medicine, University of Birmingham, Birmingham, UK.

Background: IBD, both Crohn's disease and ulcerative colitis, is associated with significant functional disability. Gastrointestinal symptoms alone are not the sole purpose of the interaction between patients and providers. In order to ascertain patients' disabilities, we utilized the recently developed IBD Disk to help determine their functional concerns and initiate relevant conversation. Read More

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A systematic review and meta-analysis on the efficacy of physiotherapy intervention in management of lumbar prolapsed intervertebral disc.

Int J Health Sci (Qassim) 2021 Mar-Apr;15(2):49-57

Department of Physiotherapy, Guru Jambheshwar University of Science and Technology, Hisar, India.

Objective: The objective of this meta-analysis and systematic review is to analyze the efficacy of physiotherapy interventions in management of lumbar prolapsed intervertebral disc (PIVD).

Method: Randomized controlled trials (RCTs) were searched in PubMed and Cochrane Library using related keywords and advanced option, from commencement to January 2019. Quality of researches was assessed by PEDro scoring. Read More

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Clinical experience with the AKT1 inhibitor miransertib in two children with PIK3CA-related overgrowth syndrome.

Orphanet J Rare Dis 2021 02 27;16(1):109. Epub 2021 Feb 27.

Dermatology, Children's Health Ireland at Crumlin, Dublin 12, Ireland.

Background: PIK3CA-related overgrowth spectrum (PROS) refers to a group of rare disorders, caused by somatic activating mutations in PIK3CA, resulting in abnormal PI3K-AKT-mTOR pathway signalling. Significant associated morbidity is frequently observed, and approved treatments are lacking. Miransertib (ARQ 092) is a novel, orally available, selective pan-AKT inhibitor with proven in vitro efficacy. Read More

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February 2021

Impact of game jam learning about cultural safety in Colombian medical education: a randomised controlled trial.

BMC Med Educ 2021 Feb 25;21(1):132. Epub 2021 Feb 25.

CIET-PRAM, Department of Family Medicine, McGill University, 5858 Chemin de la Côte-des-Neiges 3rd Floor, Suite 300, Montreal, Quebec, H3S 1Z1, Canada.

Background: Cultural safety, whereby health professionals respect and promote the cultural identity of patients, could reduce intercultural tensions that hinder patient access to effective health services in Colombia. Game jams are participatory events to create educational games, a potentially engaging learning environment for Millennial medical students. We set out to determine whether medical student participation in a game jam on cultural safety is more effective than more conventional education in changing self-reported intended patient-oriented behavior and confidence in transcultural skills. Read More

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February 2021

Development and Feasibility of a Web-Based Decision Aid for Patients With Ulcerative Colitis: Qualitative Pilot Study.

J Med Internet Res 2021 02 25;23(2):e15946. Epub 2021 Feb 25.

Ingham Institute for Applied Medical Research, South Western Sydney Clinical School, The University of New South Wales, Sydney, Australia.

Background: Shared decision making (SDM) is becoming an important part of ulcerative colitis (UC) management because of the increasing complexity of available treatment choices and their trade-offs. The use of decision aids (DA) may be effective in increasing patients' participation in UC management but their uptake has been limited due to high attrition rates and lack of a participatory approach to their design and implementation.

Objective: The primary aim of this study is to explore the perspectives of Australian patients and their clinicians regarding the feasibility and acceptability of myAID, a web-based DA, in informing treatment decisions in UC. Read More

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February 2021

Rationale, Methodological Quality, and Reporting of Cluster-Randomized Controlled Trials in Critical Care Medicine: A Systematic Review.

Crit Care Med 2021 06;49(6):977-987

Department of Critical Care Medicine, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.

Objective: Compared with individual-patient randomized controlled trials, cluster randomized controlled trials have unique methodological and ethical considerations. We evaluated the rationale, methodological quality, and reporting of cluster randomized controlled trials in critical care studies.

Data Sources: Systematic searches of Medline, Embase, and Cochrane Central Register were performed. Read More

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Mucopolysaccharidosis Type I: Current Treatments, Limitations, and Prospects for Improvement.

Biomolecules 2021 01 29;11(2). Epub 2021 Jan 29.

Immusoft Corp, Minneapolis, MN 55413, USA.

Mucopolysaccharidosis type I (MPS I) is a lysosomal disease, caused by a deficiency of the enzyme alpha-L-iduronidase (IDUA). IDUA catalyzes the degradation of the glycosaminoglycans dermatan and heparan sulfate (DS and HS, respectively). Lack of the enzyme leads to pathologic accumulation of undegraded HS and DS with subsequent disease manifestations in multiple organs. Read More

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January 2021

Nasal ventilation and rapid maxillary expansion (RME): a randomized trial.

Eur J Orthod 2021 06;43(3):283-292

Discipline of Orthodontics and Paediatric Dentistry, School of Dentistry, Faculty of Medicine and Health, The University of Sydney, Australia.

Objective: To assess three rapid maxillary expansion (RME) appliances in nasal ventilation.

Trial Design: Three-arm parallel randomized clinical trial.

Methods: Sixty-six growing subjects (10-16 years old) needing RME as part of their orthodontic treatment were randomly allocated (1:1:1 ratio) to three groups of 22 patients receiving Hyrax (H), Hybrid-Hyrax (HH), or Keles keyless expander (K). Read More

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Internship commencement during COVID-19: the impact of an extended induction model.

Ir J Med Sci 2021 Feb 8. Epub 2021 Feb 8.

Beaumont University Hospital, Dublin, Ireland.

Background: The COVID-19 pandemic necessitated an enforced 8-week induction period (18 May to 12 July 2020) for all new interns in Ireland. These unprecedented circumstances presented a unique opportunity to assess this induction period.

Aim: To assess the impact of a prolonged induction period on the technical abilities of interns embarking on their clinical careers. Read More

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February 2021

Are do-not-resuscitate orders associated with limitations of care beyond their intended purpose in patients with acute intracerebral haemorrhage? Analysis of the ABC-ICH study.

BMJ Open Qual 2021 02;10(1)

Division of Cardiovascular Sciences, The University of Manchester, Manchester, UK

Implementation of an acute bundle of care for intracerebral haemorrhage (ICH) was associated with a marked improvement in survival at our centre, mediated by a reduction in early (<24 hours) do-not-resuscitate (DNR) orders. The aim of this study was to identify possible mechanisms for this mediation. We retrospectively extracted additional data on resuscitation attempts and supportive care. Read More

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February 2021

Gastrointestinal symptoms following treatment for anorexia nervosa: A systematic literature review.

Int J Eat Disord 2021 Jun 2;54(6):936-951. Epub 2021 Feb 2.

Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, Food & Mood Centre, School of Medicine, Barwon Health, Geelong, Victoria, Australia.

Objective: Gastrointestinal (GI) disturbances are a frequent and burdensome experience for patients with anorexia nervosa (AN). How GI symptoms respond to current interventions is not well characterized, yet is critical to facilitate treatment success, and to inform the development of new treatments for AN. Therefore, the aim of this systematic review was to identify which treatments are effective in improving GI symptoms in patients with AN. Read More

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Progressive survival improvement of incident dialysis patients in a tertiary center, Ireland.

Ir J Med Sci 2021 Jan 14. Epub 2021 Jan 14.

Department of Nephrology & Transplantation, Beaumont Hospital, Dublin, Ireland.

Background: The survival of incident dialysis patients' end-stage kidney disease in some European and American has been reported to improve in modern era compared to earlier periods. However, in Ireland, this has not been well documented.

Aim: To investigate the survival outcomes of incident end-stage kidney failure dialysis patients in a tertiary center over a 24-year period, 1993-2017. Read More

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January 2021

Structural Behavior of Fibrous-Ferrocement Panel Subjected to Flexural and Impact Loads.

Materials (Basel) 2020 Dec 11;13(24). Epub 2020 Dec 11.

School of Civil Engineering, SASTRA Deemed to be University, Thanjavur 613404, India.

Ferrocement panels, while offering various benefits, do not cover instances of low and moderated velocity impact. To address this problem and to enhance the impact strength against low-velocity impact, a fibrous ferrocement panel is proposed and investigated. This study aims to assess the flexural and low-velocity impact response of simply supported ferrocement panels reinforced with expanded wire mesh (EWM) and steel fibers. Read More

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December 2020